Physiotherapeutic instrument



Nov. 19, 1968 E. H. STREHLER 3,411,496

PHYSIOTHERAPEUTIC INSTRUMENT 2 Sheets-Sheet 1 "Filed Nov. 23, 1965 In venfor ErnsZHJD-GZZer Nov. 19, 1968 E. H. STREHL ER PHYSIOTHERAPEUTIC INSTRUMENT 2 Sheets-Sheet Filed Nov. 23, 1965 I72 veniof EPWS HSTFeZLZer Y a a/www gfw United States Patent 3,411,496 PHYSIOTHERAPEUTIC INSTRUMENT Ernst Heinrich Strehler, Zurich, Switzerland, assignor to Heinrich vSchmid, Rapperswil, Switzerland, a firm Filed Nov. 23, 1965, Ser. No. 509,338 Claims priority, application Austria, Nov. 23, 1964, 9,859/ 64 7 Claims. (Cl. 12824) ABSTRACT OF THE DISCLOSURE vA physiotherapeutic instrument particularly for massage purposes having a sleeve adapted to be laid against the parts of the human body to be treated and which includes a multiplicity of air chambers which can be filled separately and which is connected with a compressor together with a control device having a rotatable distributor and regulating means acting on the control device to change the sequences of the compressed air to the air chamber.

This invention relates to a physiotherapeutic instrument suitable for massage, having at least one sleeve capable to be laid against the parts of the body to be treated, said sleeve being provided with a multiplicity of air chambers that can be filled separately, and with a compressor for producing compressed air. Also a control arrangement is provided which carries the compressed air to the air chamber in the sequence of their arrangement, one after the other, and which will let said air under pressure out again as soon as the second following air chamber or else one that is even still farther ahead will be filled, so that a progressive shifting of the pressure takes place along the sleeve.

Such an instrument is used in order to promote the blood circulation and for the massage of the human body. In many cases considerable successes, particularly with regard to support of the activity of the heart, have already been achieved with this instrument. However in a number of other cases the use of this instrument, for reasons that have not been explained so far, would either not bring the expected success or even brought about relapses in the condition of the patient treated.

In order to be able to recognize the cause of this unsuccessful application of known instruments in a part of the cases and in order to be able to recognize the reasons for the relapses in some cases, it was necessary first of all to make a careful investigation of the method of action of the known instrument, particularly in view of its reciprocal effects with the parts of the body treated.

In the case of the known instrument, a section of the sleeve laid against that part of the body that is to be treated is placed under pressure, in order to move the blood in the veins, and this section under pressure is shifted through the corresponding filling and emptying of the air chambers of the sleeve, step by step, in the direction of the flow of the venous blood, therefore in the direaction of the heart. With each step, sections of the veins that have been newly engaged by the section under pressure are being squeezed out, While those sections of the veins which have been emptied and are now freed of the section under pressure are again filled on the backside "ice and the relapses in some cases, where the instrument had been applied, were to be traced back 'to an insufficient disposition of the pertinent patient for this method of treatment, or to defects in the method of operation of the instrument or of its physiological effect on the pertinent patient which are not yet clearly known in detail.

Therefore, it was necessary to investigate the problems in connection with which this invention is based, whether or not in case of an unsuccessful application of the instrument and particularly in cases of relapse, indisposition of the patients or defects of the instruments had been the cause, and in case that the result of the investigation should point to defects of the instrument to develop the instrument further, in such a manner that an improvement of the success ratio in the case of treatment would be achieved with the further-developed instrument and particularly that relapses would be practically impossible.

According to the invention, this will be achieved in that the instrument is equipped with regulating means acting upon the control arrangement, for the change of the temporal sequence of feeding in of the compressed air into the air chambers and, thus, for the regulation of the speed of migration of the pressure shift.

It has turned out that the possibility of regulating the migration speed is of decisive importance, in order to be able to adjust the desired speed of flow of the blood in the veins. Clinical experiments have shown that optimum treatment results will be achieved by the tuning of the migration speed of the pressure shift to the pulse frequency of the heart. Since, as is well known, the pulse frequency of the heart and with it the circulation speed of the blood can vary within considerable ranges, the migration speed of the pressure shift must, therefore, also be regulated correspondingly. With this realization it also becomes clear for what reasons it was possible to achieve consider-able successes in many instances with the known instrument and why, on the other hand, however, no success could be achieved in a number of cases without any evident reason. Obviously in the successful case, the migration speed of the pressure shift, which in the known instrument had been fixedly pre-e-stablished, had agreed about with the speed of flow of the blood, in the case of the patient treated, whereas in cases of considerable deviations of the fixed migration speed of the pressure shift from the speed of flow of the blood, no success could be achieved.

Preferably the control device contains further means for the throttling of the air stream in at least that spot in the flow path leading to the air chambers, which means will cause a throttling of at least the inflow to the air chambers at least over a part of the entire inflow period.

With the aid of these throttling means, one can change over the progressive pressure shift along the sleeve into a pressure wave, continuously progressing along the sleeve, that is the pulse-like filling in the case of the known instrument, which results in a pressure impulse progressing step by step, will be replaced by a continuous filling which results in a continuously progressing pressure wave.

Such a continuously progressing pressure Wave is re quired, as clinical investigations have shown, especially in the case of treatment of diseased tissue, since in the case of a step-by-step progressing pressure impulse, con gestions in the veins may occur in the case of diseased tissue, which congestions can lead to very dangerous aftereffects such as, for example, thrombosis.

It is therefore an object of the invention to provide the means for the throttling of the air current to be attached on a distributor, which distributes the compressed air to the feed lines of the individual air chambers. One design is particularly advantageous, where the throttling means will partly cover up the feed openings during the feed in of the compressed air during a part of the entire inflow time, so that the inflow of the air into the air chamber during this part of the inflow time will be throttled. For this purpose, the distributor mouth, which can be moved past the feed-in openings, can advantageously be equipped with a control slot extending in the direction of movement and used as a throttling means, said slot covering the feed openings over a part of its entire length. For practical purposes a control slot can, at the same time, be developed, in such a manner that its length is at least equal to the distance of two adjacent feed-in openings, and that its cross section of flow will increase counter to the direction of movement of the distributor, so that during the movement of the distributor past one of the feed-in openings, the cross section of flow of that part of the control slot located at any one time before the feed-in opening, will increase.

Furthermore, the removal of air from the air chambers can also take place advantageously by means of the above mentioned feed lines and there can be provided for this purpose, a second control slot for the removal of air on the distributor behind the control slot for the feed in of compressed air, the flow cross section of said second slot also increasing counter to the direction of movement of the distributor.

Furthermore, the instrument may be equipped advantageously with means for regulating the pressure of the compressed air fed to the air chambers. Such a possibility of regulation is especially important for the purpose of adaption to the physical constitution of the patient, because, for example in the case of obese patients, with their veins lying deep, a greater pressure should be applied than in the case of lean people where the veins are located directly below the skin.

The invention has been explained in more detail in the following description when considered in connection with the accompanying drawings in which:

FIGURE 1 is a diagrammatic view partly in section showing an instrument according to the invention,

FIG. 2 is a plan view showing the control device of the instrument of FIG. 1, with a gearing and engine,

FIG. 3 is a partial section through the control device of FIG. 1 taken on line III-III in the direction of the arrows,

lFIG. 4 is a plan view of a control slide with control s ots,

FIG. 5 is a side view of a schematic presentation of the mode of operation of the sleeve in the case of a control slide according to FIG. 4 and in three different positions A, B and C,

FIG. 6 is a sectional view of another control slide, and

FIG. 7 is a side view of a schematic presentation of the mode of operation of the sleeve in the case of a control slide according to FIG. 6.

A compressed air distributor has a housing 1 and a control slide 2 mounted rotatably therein, FIGS. 1 and 3. On the periphery of the cylindrical wall 3 of the housing 1, there are twenty-four pipes 4 located at a distance that remains the same, one from the other, said pipes representing pressure release openings, FIGS. 1 to 3. Each of these pipes 4 is connected by means of hoses 6 with a pipe 5, FIG. 1, of which there are twenty-four pipes attached to a stationary level plate 7. The pipes 5 are distributed in two rows of twelve pipes 5 each. The plate 7 is located on the outside of a transportable housing 8 as a mounting, which housing encompasses all construction elements shown in FIG. 1, except for a sleeve 9 with lines 10 and a plate 11 with pipes 12. With this plate 7 can be connected, in a manner to be explained, various plates 11, depending on the size of the sleeve 9 to be used, the plate 7 representing the pressure tapping point of the housing 8.

The pipes 4 and 5 are connected with one another in such a manner, that the lines 6 of adjoining pipes 4 are attached in one sequence to likewise adjoining pipes 5.

The pipes 4a, 4b, 40, FIG. 2, are thus connected with the pipes 5a, 5b, 50, FIG. 1. The twelfth pipe 4x is connected with the twelfth pipe 5x, that is to say, the last one in the series shown. The thirteenth pipe 4y is connected with the thirteenth pipe 5y, not shown. The thirteenth pipe 5y lies like a cover behind the pipe 52: or 5a in FIG. 1 and represents the beginning of the second row of pipes 5. The two rows of pipes are in parallel to one another. The twenty-fourth pipe 4z is connected with the twenty-fourth, not shown, pipe 52. The twenty-four pipes 5 have been placed in two rows for reasons of space saving.

The control slide 2, rotatable around the axis 13, is driven by an electric motor 14 through an infinitely variable gearing 15. The shifting of the speed transmission 15 takes place by hand by means of a control grip 16, FIGS. 1, 2

The compressor 17 is operated by an electric motor 18 and feeds into an expansion chamber 19. By means of an adjustable pressure reduction valve 20, the pressure flowing into housing 1 and existing in the sleeve 9 can be varied between about 40 and mm. Hg-column, FIG. 1. The pressure has been built up in the connecting pipe 21 and in the bores 22 and 23, and the compressed air, at a turn of the control slide 2 in the housing 1, is fed under control into the pipes 4, one after the other.

The control slide 2 in its periphery carries a plate 24 in which are located two control slots 25 and 26, FIGS. 3 and 4. The control slide 2 and the plate 24 move in the direction of the arrow 27, FIGS. 3 and 4. The control slot 25 serves as a duct of the compressed air from the control slide 2 to the sleeve 9, FIG. 1, and the control slot 26 serves for a controlled outflow of the compressed air from the sleeve 9 to the inside of the housing 1 and through an opening 28 into the open air. The flow cross section of the control slot 25 has been developed in decreasing form, pointing into the rotational direction 27; the same being true of the control slot 26. In FIG. 3 the two pipes 41) and 4c are supplied with compressed air, and compressed air flows from the sleeve 9 through the pipe 4a, housing 1 and opening 28.

The sleeve 9 has eight individual gas chambers, that is, in the example eight compressed air chambers 29, FIG. 1. Each chamber 29 stretches in the transverse direction of the sleeve, the individual chambers 29 lie parallel one to another and they may be formed, for example, by vulcanizing or glueing. The individual chambers 29 are separated air tight one from the other, and each chamber 29 has a line 10 connected thereto, FIG. 1. The ends on one side of the lines 10 connect into the plate 11. The sleeve 9 with lines 10 and plate 11 will result in a unit that can be' attached to or removed from housing 8, FIG. 1. A plate 11 with eight pipes 12 has been attached to sleeve 9 provided with eight chambers 29. If the plate 11 is attached in sealing relationship to the plate 7 by means of a screw handle 30, then eight pipes 5 will be connected with eight pipes 12. The other sixteen openings of the pipes 5 are closed air tight by means of the plate 11. Therefore, a plate 11 with twelve lines 10 would belong to a sleeve with twelve chambers and half of all pipes 5 would be connected to lines 10 and so forth.

The method of operation of the device according to FIGS. 1 to 4, in the case of an example according to FIG. 5, will be as follows. The sleeve 9 with the eight chambers 29, placed around a line 31 that can be compressed, is to serve for the movement of a liquid 32 in the direction of the arrow 33. In the present position of the rotating slide 2, according to FIGS. 3 and 4, compressed air flows from the chamber 29a by line 10, pipe 5a, line 6, pipe 4a and opening 28, into the open air (FIGS. 1 and 5A). The compressed air escapes in throttled condition from the chamber 29a according to FIG. 5A, since the pipe 4a will be opposite to the small flow cross section of the control slot 26, FIGS. 3, 4. The hose 31 may expand at the spot of the chamber 29a and will suck in liquid. The chamber 2% is connected with the pipe 4b by means of the pipe 5b, and said pipe 4b will be opposite to the large flow cross section of the control slot 25, FIGS. 1, 3, 4 and 5A. The chamber 29b is under full pressure and has closed the hose 31, so that the liquid 32 cannot flow counter to the direction of the arrow 33, for example as a result of gravity. The chamber 290 will be supplied with compressed air, since it is connected with the pipe 4c by means of the pipe 5c, whereby the pipe 4c is opposite to the tapered flow cross section of the control slot 25, FIGS. 1, 3, 4 and 5A. The compressed air flows throttled from the control slide 2 into the pipe 46, so that the hose 31 will be compressed at the chamber 29c, while displacing the liquid, FIG. 5A. When continuing to turn the control slide 2, the compressed air will have flowed out entirely from chamber 29a, the pipe 4b is connected with the control slot 26, and the chamber 290 is completely under pressure by means of the pipe 4c. The pipe 4d will be opposite to the narrow slot of the control slot 25 and the chamber 29d of the sleeve 9 is now fed compressed air in a throttled manner, FIGS. 3 and 5B. The liquid 32 has been moved further by the width of one chamber in the direction of the arrow 33, FIGS. 1 and 5. The next position is then shown in FIG. 5C. The next chamber 29e is supplied with throttled compressed air, since the pipe 4e is opposite to the control slot 25. From FIG. 5 it is apparent that always one spot or section of the sleeve 9 will completely close the hose 31 and that this closing spot or section progresses like a wave in the direction of the arrow 33 within the sleeve. In FIG. 5A this spot is located near the chamber 29b. In FIG. 5B the spot or section lies by the chamber 290, and in FIG. 5C it is the spot or section by the chamber 29d.

The length of the control slot 25 is equal to the distance of three adjoining pipes 4, FIGS. 3 and 4. That means at the most, three pressure release openings 4 can be opposite the control slot 25 and can be supplied with compressed air. This is done for reasons of inertia of the flowing air. Although, according to the illustrations in FIG. 5, always only two chambers are supplied with compressed air, the pipe 4d will be opposite the control slot 25 after a slight further turn of the slide 2, according to FIG. 3, whereby the pipe 4b will also still be supplied with compressed air.

FIG. 6 shows another design of a control slide 34 in a simplified form in the case of a straight line shift in the direction of the arrow 35 as compared to the stationary pipes 36, 37 and 38. A control slot 39 of the control slide 34 is connected with a pressure hose or connection 40. The length of the control slot 39 is equal to the distance of two adjoining pipes 36, 37 and 38 and so on. The flow cross section of the control slot 39 is to remain the same across the whole length. In the position of the control slide 34, according to FIG. 6, assumed at the moment, the full air pressure is eilective in both pipes 36 and 37 and the chamber 41, connected with the pipe 36, has completely compressed a hose 42, FIG. 7. The chamber 43, connected with the pipe 37, has likewise compressed the hose 42 completely. It the control slide 34 is shifted further, the high pressure will still predominate only in the pipe 37 and, thus, in the chamber 43. The chamber 41 is without pressure andthe hose 42 is locked only 'by the chamber 43. In the .next position both pipes 37 and 38 are in connection with the control slot 39, now the hose 42 is again locked by two chambers 43 and 44. Thus, the hose 42 is locked alternatingly with one or with two chambers and the liquid in the hose 42 is moved.

If the device is developed according to FIGS. 6 and 7, then the continuous pressure wave in the sleeve 9 will show fairly precipitate transitions of pressure increase and pressure decrease. This strong pressure wave is particularly suitable for healthy tissue and thus as a preventative massage and less as a therapy.

A sleeve 9 with eight chambers 29 has been shown in FIG. 1. Altogether twenty-four gas chambers 29 can be attached to the housing 8, these twenty-four chambers can be distributed in a different number of sleeves. It will be advantageous to develop sleeves with six, twelve and twenty-four chambers.

The sleeves can be placed, for example around the arms, legs and buttocks. The sleeves have to be placed in such a manner on the part of the body, that the pressure wave (arrow 33 in FIG. 1) in the sleeve 9 will move in the direction toward the heart. The venous blood of the great blood circuit returning to the heart also flows in this direction.

The device can be used for correction of disturbances of peripheral circulation, for the following reasons;

Whenever the flaps acting as reversing valves, which are located in the vein, are no longer intact in the case of certain vascular diseases, the complete revolution or turn over of the blood which reaches the artery from the heart via a pulse wave and from here slowly flows back in the vein toward the heart, is no longer guaranteed. The blood particles which are not circulating may form a kind of a sump in the vein, and this sump may lead to thrombosis. With the help of the device, the carbonic acid containing dark blood which is in the vein will be moved in the direction of the heart with a compressed air sleeve attaching on the outside part of the body. In FIGS. 5 and 7 the hose 31 and 42, for example, represents the vein. With this forced flow, any blood sump existing in the vein will be emptied out and all the blood will be rotated and, thus, will be carried back to the regenerating organ. The passive congestion of blood just described occurs because vein flaps were no longer intact. A congestion of blood however can also occur in the case of extended sickbed condition or after a major operation. With the help of the device, the blood circulation can be maintained and thus serves for the prevention of thrombosis or embolism.

Because of various sicknesses it is also possible that the lymphatic vessels too may become inefiective in their functioning. The muscular pumps are then no longer in a position to squeeze out the lymphatic vessels located between the skin and the bones, so that the blood and the collected wastes of metabolism can no longer be emptied out into the vein, in order then to be carried back to the regenerating organ. In a diseased lymphatic area, seas of waste and sumps of waste with harmful effects will develop. With the help of the device which takes over the work of the muscular pumps, the lymphatic vessels are squeezed out and the wastes are carried to the catabolism organs.

It is also possible that disturbances will occur in the arteries which bring the blood that has been moved by the heart into circulation, as a result of which congestions of blood and under-nutrition of the tissues will occur. The latter under bad conditions may lead to gangrene. In this case the device will bring about an improved inflow of fresh blood because a suction will develop in the artery through an accelerated flow off of used up blood. Thus, the device can be used as a preventative measure, in order to avoid accumulations of blood sumps. If ailments of the vein, lymphatic vessels and the arteries are present, then the non-circulating blood will be moved by means of the device and thus the blood sump will be carried back to the regenerating organs. Above all, in the case of this last healing application, the communication speed of the pressure impulse developing in the sleeve must be small and a speed of about 0.2 to 0.4 m./ sec. has proven itself effective. With this speed of the pressure im pulse continuing as a pressure wave in the sleeve, the stagnating blood will be moved, for example in the vein toward the heart. In the case of the healing application of the device, one must compress and'decompress the arteries and veins gently, that .is the course of pressure must be rounded and must take place without any sudden transition. By means of the shape of the control slots 25 and 26 of the plate 24, a gentle rise in pressure and a somewhat steeper but not yet sharp decrease of the pressure will be achieved, if one represents the pressure wave continuing in the sleeve 9 in the form of a diagram of coordinates, whereby the pressure is plotted on the ordinate and the path on the abscissa.

It turned out, that the device does not need to take into consideration the pulsation and the rhythm of the heart, since in the above mentioned speed of propagation or transmission the pressure wave in the sleeve and the above mentioned pressures, both the pulsation of the artery as well as the rhythm of the heart of the vein close to the heart, is not impeded. Thus, the device is not controlled by the heart. With the known device mentioned in the beginning, where the individual pressure impulses occur in the sleeve one after another, it will not be possible to move any stagnating blood at such a low transmission speed of the pressure impulses of 0.2- 0.4 -m./sec., since after each individual pressure impulse the blood can again flow counter to the direction of the heart. Only in the case of very high frequency could the inertia of the blood be sutficient to move the stagnating blood. Thus, the known device cannot be used for 'healing of already existing blood sumps but merely as a preventative treatment in the case of a general health massage.

In the case of the device according to the invention and in consequence of the repeated coverage of the control slot 25 by pressure release openings, 4, a steady return flow insurance of the blood-conducting line is guaranteed, even at the smallest transmission speed of the pressure wave. Because of the special development of the control slots 25 and 26 according to FIG. 4, a course of the pressure wave will be achieved which is particularly suitable for therapy.

I claim:

1. Physiotherapeutic instrument suitable for massage comprising at least one sleeve adapted to be laid against the parts of the human body that are to be treated, said sleeve being provided with a multiplicity of air chambers that can be filled separately, a compressor for the production of compressed air, a control device with a rotatable distributor driven by a revolving motor to carry the compressed air to the air chambers in the sequence of their arrangement one after another and to permit the compressed air to escape again as soon as the second next air chamber or one lying even farther ahead is being filled, so that a shift of pressure continuing along the sleeve will take place, regulating means acting onthe control device for changing of the temporal sequence of the feed-in of the compressed air to the air chambers and thus for the regulation of the migration speed of the pressure shift.

2. Physiotherapeutic instrument according to claim 1, in which the control device is provided with a regulatable gear within the drive of the control device as a regulating means for the change of the temporal sequence of the feed-in of the compresed air to the air chambers.

3. 'Physiotherapeutic instrument according to claim 1, in which the control device is provided with a regulatable speed within the drive of the control device as a regulating means for the change of the temporal sequence of the feed-in of the compressed air to the air chambers, the transmission including gearing which is infinitely variable.

4. Physiotherapeutic instrument according to claim 1, in which the control device is provided with means for throttling the stream of air in at least one spot in the flow path to the air chambers in order to bring about a throttling of at least the flow into the air chambers at least as to a part of the entire flow-in period.

5. Physiotherapeutic instrument according to claim 1, in which the control device is provided with means for throttling the stream of air in at least one spot in the flow path to the air chambers in order to bring about a throttling of at least the flow into the air chambers at least as to a part of the entire flow-in period, the means for the throttling of the air stream being attached to a distributor which disributes the compressed air to feed lines of individual air chambers, and the mouth of the distributor which can be moved past the feed-in openings is provided with a control slot as a throttling means extending in the direction of movement whereby the slot will partially cover up the feed-in openings over a part of its entire length.

6. Physiotherapeutic instrument according to claim 1, in which the control device is provided with means for throttling the stream of air in at least one spot in the flow path to the air chambers in order to bring about a throttling of at least the fiow into the air chambers at least as to a part of the entire flow-in period, the means for the throttling of the air stream being attached to a distributor which distributes the compressed air to feed lines of the individual air chambers, and the mouth of the distributor which can be moved past the feed-in openings is provided with a control slot as a throttling means extending in the direction of movement whereby the slot will partially cover up the feed-in openings over a part of its entire length, the length of the control slot being at least equal to the distance of two adjoining feed-in openings and the flow cross-section of the control slot will increase counter to the direction of movement of the distributor so that during the movement of the distributor past one of the feed-in openings, the flow cross-section of that part of the control slot which at that time is in front of the feed-in opening does increase.

7. Physiotherapeutic instrument according to claim 1, in which the control device is provided with means for throttling the stream of air in at least one spot in the flow path to the air chambers in order to bring about a throttling of at least the flow into the air chambers at least as to a part of the entire flow-in period, the letting out of air from the air chambers taking place through feed lines and for this purpose a control slot for letting out of the air is attached to a distributor behind the control slot for the feed-in of compressed air.

References Cited UNITED STATES PATENTS 2,345,073 3/1944 Rosett.

2,528,843 11/1950 Poor 128-24 2,781,041 2/1957 Weinberg 128--60 3,177,866 4/1965 Wesslund 128-24 2,533,504 12/1950 Poor 128-24 LAWRENCE W. TRAPP, Primary Examiner. 

